Consensus Statement for the Emergency Medicine 2022-2023 Residency Application Cycle Regarding Emergency Medicine Away Rotations

April 4, 2022

The COVID-19 pandemic created unique challenges for medical students, clerkship directors, program directors, and student advisors related to multiple aspects of the residency application process. Due to pandemic-related restrictions, the Coalition for Physician Accountability (CoPA) has issued guidelines on these topics for the past two application seasons. The Emergency Medicine (EM) community has subsequently released specific recommendations for applicants to our specialty (1-3). This year, CoPA is not issuing updated guidelines and as a result, there remains ambiguity and variability in advising practices regarding emergency medicine rotations including away rotations (4).

To address this and the need for formalized guidance, the above organizations have developed consensus guidelines related to expectations for emergency medicine rotations based on the best available evidence and practices. The purpose of this statement is to provide clarity about this particular aspect of the application process and to optimize equity and consistency. An additional intent is to recognize these rotations as valuable finite resources and assure they are available to all applicants pursuing EM residency training (5). Students need a minimum of one Standardized Letter of Evaluation (SLOE) to apply to emergency medicine. Two SLOEs are preferred by many programs. These guidelines apply to the Main Residency Match and do not apply to students who have contractual obligations with the military or are applying to the military match.

We recognize that there is not a one-size-fits-all model and there are certain groups of students who may need additional rotations.

Recommendation 1:
The majority of students applying to emergency medicine should aim to complete a total of TWO core rotations (four-week sub-internship experience that can provide a SLOE) in emergency medicine.

Recommendation 2:
We recognize that there are some unique circumstances in which a student may benefit from a third EM rotation. Some examples of these circumstances may include students who have:
• A gap in medical education/leave of absence
• Matriculated in a dual degree program
Please consult with an experienced EM faculty advisor and refer to advising resources provided by ASC-EM and CDEM for additional guidance.

References

1. Consensus Statement on the 2020-2021 Residency Application Process for US Medical Students Planning Careers in Emergency Medicine in the Main Residency Match. https://www.emra.org/be-involved/be-an-advocate/working-for-you/residency-application-process/
2. Consensus Statement on the 2021-2022 Emergency Medicine Residency Application Cycle Part I: Emergency Medicine Rotations and Letters. https://www.emra.org/be-involved/be-an-advocate/working-for-you/match-cycle-2022/
3. Recommendations on Program-Sponsored Events During the 2021-2022 Interview Season (2021)
   https://www.saem.org/docs/default-source/cdem/cdem_cord-statement-2021-2022-recruitment-season-1.pdf?Status=Temp&sfvrsn=ebb0e480_2.
4. Zhang XC, Gordon D, Lutfy-Clayton L, Franzen D, Wallenstein J, Shandro J, Wilson D, Kiemeney M, Pelletier-Bui A, Ren R. Away Rotation Applications in Emergency Medicine: Medical Student Behaviors, Outcomes, and Stressors. J Emerg Med. 2022 Jan 22:S0736-4679(21)00914-8. doi: 10.1016/j.jemermed.2021.11.008. Epub ahead of print. PMID: 35078704.
5. Kiemeney M, Franzen D. Availability of Emergency Medicine Away Rotations. AEM Educ Train. 2020 Jul 1;5(2):e10487. doi: 10.1002/aet2.10487. PMID: 33842807; PMCID: PMC8019196.